Bandl's Ring Uterus Definition, Symptoms, Causes, Treatment

The aberrant junction between the two human uterine segments is referred to as Bandl's ring or pathological retraction ring, and it is a late symptom of labor obstruction. Prior to the commencement of labor, the connection between the lower and upper portions of the uterus is a slightly enlarged ring. After the cervix has achieved maximum dilation in atypical and obstructed labors, subsequent contractions force the muscle fibers in the myometrium of the upper uterine segment to shorten, making the regularly contracting upper segment thicker and shorter. It is possible to see or feel the ridge of the pathological ring of Bandl's rising all the way up to the umbilicus in some cases. If left untreated, the lower portion grows thinner and more strained, which could cause uterine rupture. 

Bandl's Ring Definition

A pathologic retraction ring also known as Bandl's ring of the uterus is a constriction that is connected with obstructed labor. This constriction is present at the intersection of the thinned lower uterine portion and the thick stretched upper portion of the uterus.

Bandl's Ring Symptoms

A Bandel's ring, also known as a retraction ring, is something that emerges from a physiological ring and is frequently, but not always, the cause of obstructed labor. Sometimes it can be observed as an indentation in the abdominal region, which is a symptom of approaching rupture of the lower portion of the uterus. If nothing is done to prevent it, this will result in the death of the fetus, which will then lead to the death of the mother. In most cases, a cesarean delivery is performed right away if this ring is observed.

Bandl's Ring Causes

It is unknown what causes Bandl's ring to appear. It is thought that an extended labor phase may contribute to the formation of a constriction ring. Dystocia has also been suggested to play a role in both the cause and the consequences of the problem. It is believed that the incidence of Bandl's ring is 0.02%, which correlates to one case in every 5000 live births.

The baby's head or shoulders become stuck in a band formed by the uterine muscle, making it impossible to deliver the newborn through the uterine incision. This restriction may cause serious injury to the baby's head, shoulder, or neck, delaying developmental stages and increasing the risk of cerebral palsy. 

Bandl's Ring Treatment

Taking the necessary amount of time to identify the Bandl's ring is essential for the right management of this ailment. After the issue is diagnosed, a cesarean delivery is necessary, and the right uterine relaxing medications, like terbutaline, must be given. After that, an incision must be made in the Bandl's ring at the appropriate moment, in a caudad-directional manner.

Long labors and gestations with multiple fetuses are frequent risk factors for this syndrome. The ability to distinguish Bandl's ring from other disorders, such as prenatal head impaction, is crucial for appropriate management.